Pain

Contractures and Trigger Points What are they?

Contractures and Trigger Points What are they?

Before delving into what trigger points are, we must understand that in the lifestyle we lead and how common it is to have contractures which in many cases cause excruciating pain that may be accompanied by a decrease in mobility.

What is a contracture?

A contracture is an involuntary, long-lasting or permanent contraction of one or more groups of muscles. muscular.

When we have a contracture we locate a “painful ball“, this ball receives the name of Trigger Point (PG) and may be the reason that the muscle is in that contraction maintained over time, but they are not the only cause of this.

It is common to find trigger points in muscles with prolonged contraction over time, but this pathological contraction may have other origins such as a failure in the electrical system that contracts them(the nervous system) or a failure in the system of supply and removal of nutrients and waste products(vascular system).

 

What are Trigger Points?

Myofascial trigger points (TP) are very common and involve painful episodes in almost everyone’s life. Depending on whether they cause pain or not we can classify them in two:

  1. LATENT: when they cause tension resulting in decreased mobility.
  2. ACTIVE: when, in addition to the above, there is pain.

According to the study of Sola et al., they conducted a search for trigger points in 200 people, 54% of women and 45% of men presented latent PG (without pain) in the musculature of the scapular muscles. About half of this group presented alterations in the movement of the neck influencing the correct functioning of the rest due to the presence of these “little balls” without having symptoms of pain. These statistics are similar if we go to other important muscle groups such as the hip or the muscles responsible for chewing.

 

Muscle aches and pains

The voluntary musculature is the largest organ of our body, it accounts for almost half of our weight and any of the muscles that make up the muscular system can suffer pathologies that lead it to maintain a prolonged contraction(contracture).

Most of the time, in these contractures, trigger points can develop that are capable of producing pain, both in the area and at a distance, as well as associated motor problems such as muscle weakness or restriction in the range of motion that a joint can perform.

Although medicine is changing, we are used to the fact that in general, muscles and trigger points do not receive the importance they deserve as generators of dysfunction and pain, and from physiotherapy, day after day we see that this exploration is fundamental.

 

Pain at a distance?

One of the elements to take into account about trigger points is their capacity to produce pain at a distance. This is due to the fact that the nervous system, upon receiving the excitation of the trigger point in the medulla, ends up affecting neighboring neurons so that the sensation of pain travels beyond the point where it is located.

This is a characteristic of Active Trigger Points and knowing the referred pain of the muscles is a qualitative leap in the search for the possible cause of a pain.

Here are some images from the book – Pain and myofascial dysfunction – by Drs. Travell and Simons where the “x” represents the location of the trigger point and the red color represents the area of possible pain irradiation. Here we can see a clear example of headache of cervical muscle origin or knee and thigh pain due to a trigger point originating in the hip.

Referred sternocleidomastoid muscle pain

Referred sternocleidomastoid muscle pain

 

Referred gluteus minimus muscle pain

Referred gluteus minimus muscle pain

What are the causes of Trigger Points?

Current physiotherapy has a large number of tools to deactivate them, however, knowing what causes the appearance of the latent trigger point and its possible activation should be the line of work on which to propose a quality therapeutic approach.

The appearance of trigger points may be due to alterations on the nervous system and on the blood supply system, as well as to the overwork of a muscle group.

Physiotherapy in general and Osteopathy in particular has a lot to say because it has tools to diagnose and treat the alterations of all these devices of our body.

How to prevent Trigger Points?

From MIVI we advise you not to discard a visit to your physiotherapist or pain doctor of our centers, to give you a holistic view of the possible causes of this, because we have tools and knowledge that allow us to discriminate the different origins of pain and we can guide you, both in the approach, as in the referral to the competent specialist.